Daily Mail - Prostate Cancer Bigger Killer than Breast Cancer

Tuesday, 6th February 2018

Prostate cancer is now a bigger killer than breast cancer: One man dies every 45 minutes from the disease as research lags TEN years behind other formsMore than 11,800 men a year are now killed by prostate cancer across BritainDisease has overtaken breast cancer as the third biggest cancer killer in the UKDespite this, prostate cancer receives half of research funding of breast cancerDaily Mail has been campaigning for nearly 20 years to raise profile of diseaseBy Ben Spencer Medical Correspondent For The Daily Mail

Prostate cancer has become a bigger killer than breast cancer for the first time, official statistics reveal today.

More than 11,800 men a year - or one every 45 minutes - are now killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.

It means prostate cancer has overtaken breast cancer as the third biggest cancer killer in the UK, behind only lung and bowel.

Despite this, it receives less than half the research funding of breast cancer – while experts warn that treatments for the disease are trailing at least a decade behind.

But while care has leapt forward since the Mail’s ‘Dying of Embarrassment’ campaign began in 1999, it has been slow compared with the advances made on breast cancer.

Last night, charities called for action to improve survival chances for prostate sufferers.

They said that with an improvement in funding, deaths could be ‘dramatically’ reduced over the next decade.

The annual number of breast cancer deaths fell by 1,500 between 1999 and 2015, the official figures show. Over the same period, the yearly death toll for prostate cancer rose by 2,400.

In 1999, some 9,460 men died from prostate cancer, compared with 12,947 female deaths from breast cancer. Breast cancer is very rare among men, with 80 deaths in the UK in 2015.

The figures show that by 2015 – the most recent year for which data was available – male prostate deaths had risen to 11,819, surpassing the breast cancer deaths, which had dropped to 11,442.

The numbers were compiled by Prostate Cancer UK, using English data from the Office for National Statistics and the equivalent official figures for Scotland, Northern Ireland and Wales.

The ageing population is the main reason for the increase in prostate cancer deaths – with older men more likely to get an aggressive form. And men are far more likely to ignore symptoms than women.

But last night experts said the gulf in research funding is also driving the disparity.

Professor Nick James, a leading prostate cancer researcher from Birmingham University, said: ‘We are ten if not 20 years behind breast cancer in terms of research. We are playing a late game of catch-up.’

Another factor is that while screening for breast cancer is routine – with middle-aged women invited for scans every three years – tests for prostate cancer are notoriously inaccurate and there is no national screening programme.

Angela Culhane, of Prostate Cancer UK, which released the figures, said: ‘With half the investment and half the research it’s not surprising that progress in prostate cancer is lagging behind … the good news is many of these developments could be applied to prostate cancer and we’re confident, with the right funding, we can dramatically reduce deaths within the next decade.’

Men with prostate cancer wait four times longer for diagnosis than women with breast cancer – and a quarter of men wait 126 days.

Prostate cancer has received £227million of government and charity funds since 2002, less than half the £529million invested in breast cancer.

The results can be seen in the research output – with 9,300 prostate research papers published globally last year, compared with 21,000 breast cancer papers.

Gary Pettit considers himself to be one of the fortunate ones.

Six years ago, he was offered a private medical by his new employer in the City.

Even though he was just 42, a blood test revealed high levels of PSA – a protein linked to prostate cancer.

‘I had no symptoms and if I had not had that medical it would never have been picked up,’ he said.

‘I consider myself to be very lucky.’

A biopsy at the Royal Marsden Hospital in west London confirmed that he had an aggressive form of prostate cancer.

A month later, in May 2012, Mr Pettit, 48, from Loughton in Essex, had his prostate removed in an eight-hour operation.

He is now clear of the disease and is not on medication, although he needs regular check-ups, is occasionally incontinent and has suffered from impotence.

With no national screening programme for prostate cancer, most men only have a PSA test if they show symptoms, when it may be too late for effective treatment.

Mr Pettit, pictured, said: ‘It has all gone incredibly well for me. But others are not so lucky. It is astonishing prostate cancer is now a bigger killer than breast cancer.

‘There is so much awareness about breast cancer. But there is still a big taboo about prostate cancer.

‘It is a bloke-ish tendency to bury your head in the sand and not talk about it.

‘For me there was no middle ground. I never had symptoms and when I was tested it was quite aggressive, so it was just a case of going into surgery.

‘I think some men who have symptoms ignore them. They need to talk about it.

‘What has happened to me shows you can come through it.’

And the impact can be seen in the vast disparity in care.

Breast cancer has seen rapid strides in treatments in recent years – with revolutionary precision and immunotherapy drugs such as Kadcyla and Herceptin transforming the way women are treated.

But men with prostate cancer still rely on hormone treatments and chemotherapy which have in essence hardly changed in years.

Professor James said: ‘Hormone treatments have been the treatment mainstay for prostate cancer since the 1940s.’

He stressed that better hormone treatments have emerged, such as Abiraterone, but as yet prostate cancer is yet to benefit from breakthroughs in precision medicine.

‘These trials were done in breast cancer ten or 20 years ago,’ he said. ‘We are following the same pathway as breast cancer but we have to wait ten years for answers.’

The other main drawback is screening. Men over 50 are eligible for a ‘PSA’ blood test which gives doctors only a rough idea of whether they are at risk, and then sent for biopsies, which are also inaccurate.

There have been trials looking at introducing a national PSA screening programme, but Professor Mark Emberton of University College London said: ‘The great tragedy here is we have spent a lot of money on trials that have failed … the answer is MRI.’

The NHS is beginning to use more accurate MRI scans in place of biopsies, but many hospitals do not have the right equipment.

Prostate Cancer UK estimates it needs to fund £120million worth of research over the next eight years to achieve its ten-year goal to halve the number of expected prostate cancer deaths by 2026.

Ms Culhane added: ‘Plans to create an accurate test, fit for use as part of a nationwide prostate cancer screening programme, as well as developing new treatments for advanced prostate cancer, are already well underway … to achieve these aims we need to increase our investment in research.’

The breast screening programme, which offered mammograms to all women aged 50-70, is credited with saving 1,400 lives by flagging the cancer before it spreads.

But there is no national prostate screening programme as for years the tests have been too inaccurate.

Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.

Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.

But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof.

A major trial last year showed MRI scans were more accurate than biopsies, but only half of hospitals have the right equipment.

The NHS is beginning to use MRI scanners, but this is not yet routine, and still relies on patients having a PSA test or symptoms first.

A team at UCL is embarking on a trial of MRI without PSA or symptoms, but the research is at an early stage and it will be several years until results are produced.

The lack of an accurate test means many men undergo treatment they do not need. Currently, 20,000 men with localised prostate cancer have unnecessary radiotherapy or surgery each year.

There is a big difference in publicity for prostate and breast cancer. The latter has been the subject of major campaigns since the early 1990s, with the pink ribbon campaign pushing up funding and awareness levels.

It was not until 2007 that Movember, the annual men’s cancer campaign, came to Britain.

Baroness Delyth Morgan of Breast Cancer Now said: ‘Comparing survival figures in this way must not hide the very real concerns that progress on breast cancer in the UK is now stalling.

'We urgently need to invest in research to stop more patients dying from breast, prostate and many other cancers.’

A Department of Health spokesman said: ‘Cancer survival rates are at a record high and are improving year-on-year … But we want to be even better.

'That’s why our research arm is currently doing a £4million cutting-edge research project into prostate cancer at The Royal Marsden, amongst other research on prostate cancer.

‘We have already committed £200million over the next two years to improve early diagnosis and care.’